As part of its future of leadership series, the NHS Confederation is exploring the financial situation facing the NHS and considering how NHS leaders should respond to the most severe contraction in finances they are ever likely to face.

Although the NHS has been given reassurance about receiving real terms growth, most commentators agree that it will in fact need to deal with a real terms fall of £8-10 billion from 2011. To create the headroom to deal with this, efficiency improvements of up to £20 billion may be required.

Many of the options of the past, which include cutting training budgets, across the board budget cuts, reducing quality and allowing waiting lists to grow have been shown to be counter-productive and can lead to extra costs.

Dealing with the downturn: the greatest ever leadership challenge for the NHS? suggests that the solution to the crisis lies in NHS leaders embracing innovation, change and efficiency and in making tough choices about the future. There are already examples in the NHS of the kind of service redesign and innovation that can help deliver savings - this needs to happen across the service.

Support for members

The NHS Confederation is keen to support members through these unprecedented challenges. Our programme of work is quickly taking shape. Specifically:

• access useful resources through website, including our Lean thinking for the NHS, Breaking the rules, and Priority setting publications
• we are actively discussing opportunities for joint working with leaders in the medical profession, the Department of Health and other national stakeholders
• a series of seminars to discuss ways through the downturn
• NHS Employers and our networks are working with members on innovative solutions to commissioning and delivering services.

Get involved